Cervical disc herniation occurs when an intervertebral disc in the neck protrudes or ruptures. This is usually caused by degeneration of the intervertebral disc, resulting in loss of mechanical integrity. The outer wall of the disc may rupture causing disc material to bulge or push out through the defect. Contact with and pressure on adjacent cervical nerve roots can cause pain radiating down the arm.
What are the symptoms of cervical disc herniation?
Symptoms of cervical disc herniation typically include radicular arm pain (brachial neuralgia) which may radiate into the shoulders, arms, and hands. Patients may experience numbness, tingling, or in severe cases weakness in the affected muscle groups. Symptoms are usually experienced in the area supplied by the cervical spinal nerve that is being compressed.
How are cervical disc herniations diagnosed?
Following a thorough clinical assessment, you will be referred for an MRI scan. The MRI will show the disc herniation and resulting nerve compression causing the symptoms.
What are the treatment options for cervical disc herniations?
A significant proportion of cervical disc herniations self–limit and do not require surgical intervention. Initial treatment includes physical therapy, anti-inflammatory and anti-neuropathic medications and lifestyle modifications . Cervical nerve root injections may also be used to alleviate symptoms.
If non-operative measure fail to control symptoms, or if neurological symptoms are present (e.g. muscle weakness), surgical intervention may be indicated. The decision on which surgical approach is most appropriate is on a case-by-case basis and can be performed from the front of the neck (anterior cervical discectomy and fusion) or the back (posterior cervical forminotomy). Anterior cervical discectomy and fusion involves complete removal of the disc causing the compression, and replacement with an interbody fusion device (‘cage’). Posterior cervical foraminotomy is performed by removing a small section of bone at the back of the neck overlying the compressed nerve root to create more space and decompress the nerve.
